can artifact on holter cause false pauses?

I am 34yr old female having shortness of breath and fainting....palps also...had a 24hr holter which came back saying 751 supraventricular ectopics and 270 ventricular ectopics....also 32 pauses exceeding 2.5 seconds, longest being 5.0 seconds.... bursts of tachy noted....low HR 38...high HR 131......some ST depression noted. I have been to cardiologist and had stress test and ecg's but not gotten results yet....I am now wearing a 21 monitor....my question is that cardiologist said there was alot of artifact on holter results....can this artifact cause the large number of pauses it recorded? Can it cause the SV and V ectopics reading also? I just have not had the chance to really talk with cardiologist about this yet and wonder how accurate this holter report is?

[ireneo]

Since you wear a monitor during daily activities, artifacts are often caused by your movement. According to a nursing site I just scanned it says:

Causes of  interference include artifact from patient movement and poorly
placed or poorly functioning equipment.
An artifact, also called waveform interference, may be seen with
excessive movement (somatic tremor). It makes the baseline of
the ECG appear wavy, bumpy, or tremulous. Dry electrodes may
also cause this problem because of poor contact.

Even poorly placed electrodes can cause false readings. My husband had to deal with this when he was volunteering in a cardiac unit. The number of PVC's and PAC's you had isn't real excessive. I hope you get clear answers soon.

[blown50sgirl]

Thanks for answering, the only thing im curious about is if this interference could have caused the pauses that were recorded...I have not been feeling very well and hope to find out some good news soon. Cant find any info about false pauses anywhere....thanks again for your reply

[ireneo]

Recordings on the monitor do not affect the heart rhythm any more than recording a movie from TV would affect the movie. You can mess up the recording but not the movie. Does that make sense? Keep a list of questions handy to ask your cardio when you see him again. That way you're not likely to forget anything. I tend to get nervous and don't care about my questions any more; I just want to get out of there. :-)

[blown50sgirl]

I worded that really wrong...haha!....what I meant was could the 32 pauses exceeding 2.5 seconds not have happened at all? That they were errors or artifact on the holter instead of actually being real pauses? When I saw the cardiologist she didnt give me any clues as to what she thinks is going on with me....she just immediately did an ekg and ordered a stress test and 21 day ecardio monitor...then did another ekg before I left....so confusing....I just want to know if Im really having these pauses or it was artifact on holter....just so frustrating!

[ireneo]

Ah, I see. I don't know the answer for that. Many of my PVC's have pretty good compensatory pauses after them. I can't time them that precisely of course. It seems if the electrodes were placed properly enough to pick up a PVC, then they're probably in good shape to pick up the pause. Many artifacts are things like blank spots that look like you've died (not good) or lots of wiggles that resemble flutter or fibrillation. At least you're getting another thorough check and they'll sort it all out.

[Wisconsin2007]

Like Irene, I can't say that I have a good answer for that.  This image:  http://www.skippinghearts.com/articles/images/ekg_artifacts.gif

shows artifacts from an event monitor. In this case I can see how the P,Q,S and T waves would be hard to interpret, but the R wave really isn't.  It's the only thing that is easily discerned on that tracing.  So if your pauses occurred with similar artifacts, I would think the overall heart rate would still have been caught.  Now if the artifacts made the tracing fluctuate wildly (which is certainly possible), then I could see how a long pause could have been missed.  

But like Irene said, the number of ectopics was pretty small relative to others, and a second look should be able to clear this all up.

[blown50sgirl]

Thanks so much for answering, I just have so many questions and I dont see my cardio till the end of this 21 event monitor. Its hard to wait so long!